Medicare & Medicaid

CMS announces changes to ‘deliver better outcomes for patients’ while safeguarding funds.

To sustain Medicare Advantage, payers and providers must rebuild collaboration through transparency and standardization.

Strategies for organizations to navigate CMS's decision to fast-track risk adjustment audits.

A new analysis of 11.6 billion Medicare claims from 2013-2023 shows physician participation rose modestly over the past decade, but exits surged — especially among older physicians, women and those in rural and shortage areas.

Jason Jobes of Norwood outlines why taking the right amount of financial risk — and investing in infrastructure — is essential for practices transitioning to VBC.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A revised CMS notice late on Oct. 15 said claims for Physician Fee Schedule and other payment programs will be processed and paid in a timely manner. The exceptions are claims for programs that have expired, such as telehealth flexibilities.

Jason Jobes of Norwood explains why the move toward value-based care is both necessary and challenging — and what physician practices can do to prepare.

Researchers examine trends for EDs, intensive care units over 10-year span.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

Ohio State researchers say the billionaire entrepreneur’s Cost Plus Drug Company exposes how insurance premiums and middlemen drive up the true cost of neurologic medications.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

A regional inspector general for the U.S. Department of Health and Human Services explains oversight of a multi-billion-dollar trend in Medicare spending.

Feds highlight huge growth in spending on wound care and why it could be problematic in health care.

At the MGMA Leaders Conference 2025 in Orlando, speakers broke down the Trump administration's effect on health policy.

Out-of-pocket costs for popular diabetes and weight-related medications nearly doubled in 2025, with nearly universal prior authorization requirements, according to new JAMA research.

From Rhode Island to California, states are experimenting with ways to funnel more money into primary care, though it’s uncertain whether those investments can rein in overall health costs.

Medicaid cuts threaten essential care for special needs children, risking their health and increasing costs. There is a better solution.

A JAMA viewpoint argues new reimbursement policies may deliver long-sought revenue to primary care, though uptake, staffing and fee cuts elsewhere cloud the outlook.

CMS announces application details as RFK calls it ‘the largest investment ever made’ to improve rural health.

MGMA, Accountable for Health offer analyses of 2026 Medicare Physician Fee Schedule.

Comments published about next year’s Medicare Physician Fee Schedule.